Healthcare Provider Details

I. General information

NPI: 1770005167
Provider Name (Legal Business Name): RASHIDAH MORISELADE AFOLARIN APN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/07/2017
Last Update Date: 07/17/2026
Certification Date: 07/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

515 S BROAD ST STE 201
TRENTON NJ
08611-1819
US

IV. Provider business mailing address

2601 HOLME AVE
PHILADELPHIA PA
19152-2007
US

V. Phone/Fax

Practice location:
  • Phone: 609-777-9700
  • Fax:
Mailing address:
  • Phone: 215-335-6562
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number26NJ00741500
License Number StateNJ
# 2
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberSP017595
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: